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  1. Re-Assessing the Triadic Model of Care for Trans Patients Using a Harm-Reduction Approach.A. F. Gruenewald - 2020 - Health Care Analysis 28 (4):415-423.
    The World Professional Association for Transgender Health’s Standards of Care, now in its seventh edition, is a frequently cited, internationally recognized, evidence-based document that details a comprehensive framework for gender-related care of trans people. However, the WPATH SOC still relies heavily in some cases on gatekeeping practices, dubbed “triadic therapy,” or a process where a trans patient is encouraged to seek out psychotherapy, and hormone therapy, and only then be able to engage in surgical options for transitioning. I use G. (...)
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  • Identity, Well-Being and Autonomy in Ongoing Puberty Suppression for Non-Binary Adults: A Response to the Commentaries.Lauren Notini, Brian D. Earp, Lynn Gillam, Julian Savulescu, Michelle Telfer & Ken C. Pang - 2020 - Journal of Medical Ethics 46 (11):761-762.
    We thank the commentators for their thoughtful responses to our article.1 Due to space constraints, we will confine our discussion to just three key issues. The first issue relates to the central ethical conundrum for clinicians working with young people like Phoenix: namely, how to respect, value and defer to a person’s own account of their identity and what is needed for their well-being, while staying open to the possibility that such an account may reflect a work in progress. This (...)
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  • Responding to Objections to Gatekeeping for Hormone Replacement Therapy.Toni C. Saad, Daniel Rodger & Bruce Philip Blackshaw - 2019 - Journal of Medical Ethics 45 (12):828-829.
    Florence Ashley has responded to our response to ‘Gatekeeping hormone replacement therapy for transgender patients is dehumanising.’ Ashley criticises some of our objections to their view that patients seeking hormone replacement therapy (HRT) for gender dysphoria should not have to undergo a prior psychological assessment. Here we clarify our objections, most importantly that concerning the parity between cosmetic surgery and the sort of intervention Ashley has in mind. Firstly, we show Ashley’s criticism of our comparison is insubstantial. We then examine (...)
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  • Reply to ‘Hormone Replacement Therapy: Informed Consent Without Assessment?’.Florence Ashley - 2019 - Journal of Medical Ethics 45 (12):826-827.
    In a previous article, I argued that assessment requirements for transgender hormone replacement therapy are unethical and dehumanising. A recent response published by the Journal of Medical Ethics criticises this proposal. In this reply, I advance that their response misunderstood core parts of my argument and fails to provide independent support for assessment requirements. Though transition-related care may have similarities with cosmetic surgeries, this does not suffice to establish a need for assessments, and nor do the high rates of depression (...)
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  • Hormone Replacement Therapy: Informed Consent Without Assessment?Toni C. Saad, Bruce Philip Blackshaw & Daniel Rodger - 2019 - Journal of Medical Ethics 45 (12):1-2.
    Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic surgery (...)
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  • GnRHa (‘Puberty Blockers’) and Cross Sex Hormones for Children and Adolescents: Informed Consent, Personhood and Freedom of Expression.David Pilgrim & Kirsty Entwistle - 2020 - The New Bioethics 26 (3):224-237.
    Ethical concerns have been raised about routine practice in paediatric gender clinics. We discuss informed consent and the risk of iatrogenesis in the prescribing of gonadotropin-releasing hormone...
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